2020 Andy Harvey Workshop Application
LAST NAME *
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FIRST NAME *
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What is your phone number? *
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Please provide your email address: *
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What is your parent's or guardian's name *
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Please provide your parent's or guardian's phone number: *
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Please provide your parent's or guardian's email address: *
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How old are you? *
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What is your street address? (Please include city and zip code) *
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Name of your school: *
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Your year at school as of the Spring 2020 semester: *
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How did you hear about the workshop? *
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If chosen will you be able to travel to and be picked up from Flagstaff as well as live in Flagstaff for a week? *
What is your tribal affiliation? (Preferred but not required to attend workshop)
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Tell us why you would like to participate in the workshop: *
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The following questions will be used for those students chosen to participate in the workshop:
If chosen for the workshop, do you feel that you are responsible enough to follow directions of workshop staff and keep yourself occupied safely during “down time”? Please explain. *
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Please indicate a roommate request if you have one:
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What is your gender identity? *
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Do you have any health issues that you or your parents feel will be important for us to be aware of? *
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Please list any food allergies: *
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What is your preferred t-shirt size? *
There is a $50 tuition fee. If chosen, are you able to pay the tuition amount before the workshop? (If not, briefly explain why you are unable to pay; there are full scholarships available.) *
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